Edit Project: Boarding Loc

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This isn't so much a project as way to track how patients physically move around the hospital. See [[Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry]] for information about it and why we needed to change it to this model. This project tracks where and when a patient '''arrives''' into a new physical location under the Medicine or ICU service. == Data Collection Instructions == === Sources for Boarding Loc DtTm === ==== [[CSS]] / [[Cognos2 Unit Starter]] ==== Usually the Cognos Unit start time from [[CSS]] or [[Cognos2 Unit Starter]] can be used as [[Boarding Loc]]. * sometimes the first [[Service tmp entry]] and first and second [[Boarding Loc]] all have the same date and time; see [[#Special Case - Can't have two Boarding Locs with same DtTm]] ==== First set of vital signs for CC ==== [[ICU Curriculum]]: The first set of vital signs is used as [[Boarding Loc]] dttm for arrival on the unit for [[Critical Care program]] admissions, if it is different from the Cognos Unit Start DtTm. ==== Erroneous Unit information in [[CSS]]/[[Cognos2 Unit Starter]] ==== Sometimes the times are not when people really show up at a location. Use what you know to be correct from chart and your knowledge of your hospital. === How to enter === You can use the [["make loc" button]] to generate and pre-populate these entries. *Use tmp fields: ** Project: '''{{PAGENAME}}''' ** start_dt and start_tm: *** enter as per Cognos initially *** before setting [[RecordStatus]] to complete update the DtTm to comply with [[DtTm for First Boarding Loc and First Service]] ** checkbox: not used for this project  ** Item: *** for the initial unit or ER and each physical move to another unit, enter the location by using the "make loc" button in [[Patient Viewer Tab Cognos ADT2]] *** if a boarding location appears in COGNOS but the patient does NOT move/arrive to that boarding location, do NOT enter that boarding location. We only capture boarding locations where the patient physically arrives (also see [[Wrong service or unit entries in Cognos]]) **** if the ward is not available in the dropdown, please notify Tina, Lisa, and Julie; Tina/Lisa will add the location to the dropdown and update the wiki as needed {{Discuss | **** leave what is in Cognos, the main office doesn't use this part for anything for home locations, but it can be used to crosscheck accuracy. ***** what is this about? [[User:Ttenbergen|Ttenbergen]] 17:42, 19 August 2025 (CDT) }} * '''no location entered''' is the default ** that entry will not be allowed in a complete record; it is automatically deleted when by Cognos Make Loc button, but needs to be removed before setting a record to complete if it is still present.  {{Combined instructions for Transfer Ready DtTm and Boarding Loc}}  ==== Special Case - Can't have two Boarding Locs with same DtTm ==== * No two different [[Boarding Loc]] records can have same start_dt and start_tm; if two locations have the same Start_DtTm in [[CSS]]/[[Cognos2 Unit Starter]] this is an error. * The date and time for these entries must be confirmed by looking at the chart, specifically orders, flowsheets, and progress notes {{DJ | It says: * Change one to be off by one minute, put a note in [[Notes field]] to check boarding location to confirm the correct date and time for the boarding locations of concern. ** how does that fit in with reviewing reality in the chart? ** I don't know what you mean by this? It means you double check the correct first service and first and second boarding loc dttm [[User:Lkaita|Lisa Kaita]] 21:14, 6 September 2025 (CDT) *** Well, it seems like this triggers an error check, so you pull the times a minute apart to overcome the error check and put a note to remind you to check later. So either the check should run later (on complete or send) or we shouldn't have it at all. But a check that just gets you to "tweak" the data to make it go away isn't a good idea. * sure if you can have the cross check on completion that would be better, the prior scenario is almost always for SICU admissions from ER [[User:Lkaita|Lisa Kaita]] 15:51, 26 November 2025 (CST) ** Julie, do you use Boarding Loc info on incomplete charts? Would either the current collection practice, or delaying the check, mess with measures or indicators? [[User:Ttenbergen|Ttenbergen]] 22:09, 26 November 2025 (CST) }} * This case is especially common in the context of [[DtTm for First Boarding Loc and First Service]] {{Ex | * Example: Not infrequently, the COGNOS data for HSC_SICU patients coming from the ER will show the first service, first boarding location (ER) and the second boarding location (SICU) as all having the same start_DtTm. Our solution for this is to change the second boarding location (SICU) to be off by one minute. }} ==== Special Case - GRA MICU boarding in GH-Emergency ==== ''This is a case of [[Patients who appear to transfer from in-patient situation to Emergency Room]], see there for more info. * Grace ICU boarding in ER choose Boarding Location GH-Emergency * Grace Main ICU choose Boarding Location and GH-Intensive Care * Grace Recovery Room (ICU) choose Boarding Location and [[GH-Recovery Room]] and enter comment Covid+ICU * For External(SDC/NFA) ICU beds choose Boarding Loc and GH-External ICU and enter exact location in comments * The [[Previous Location]] and [[Pre-admit Inpatient Institution]] would be <site>_med or <site>_ward === Special Case - Cross-program boarding === If a patient is accepted by one of our services, and is on an off-service ward, enter a [[Boarding Loc]] entry for that period. '''For medicine pts boarding in ICU''' you can use the explicit ICU entry that applies because all CC locations are explicitly included in Boarding Loc. {{DJ| what is this sentence telling me, can I not use the specific medicine entry? Why/how? What would a new collector need to know? * I have no idea, I suppose this can happen although I have not ever seen this at any of the facilities, I believe you were the original author of this so feel free to do what you want with this [[User:Lkaita|Lisa Kaita]] 13:46, 6 August 2025 (CDT) ** Julie, do you know what this is about? If the same applies for Med as for ICU in this, then lets get rid of the confusing entry. [[User:Ttenbergen|Ttenbergen]] 17:23, 6 August 2025 (CDT) *** we have one case S4_STB_Med-2892 where first3 days at SBGH ICMS then transferred to SBGH-L2CC.--[[User:JMojica|JMojica]] 16:42, 18 August 2025 (CDT) **** What else would they use? The entry would come from Cognos, no? It's entered by drop-down, so I don't think they could enter anything but the actual entry. Is this stated here really as a reminder for you, in case this happens again? If so, would it be better to store it in L_Problems table? If it is an instruction to collectors, would you explain further what you actually intend? [[User:Ttenbergen|Ttenbergen]] 17:33, 19 August 2025 (CDT) }} '''For CC patients boarding on a Med ward where we collect''', enter "GRA_Med"/"HSC_Med"/"STB_Med" as applicable. We added these boarding loc options specifically for this scenario, and they are available only for [[Critical Care program]] admissions. {{Ex | This could happen if the team runs a code on a patient and accepts care for that patient, but for a period of time hasn't yet moved the patient. For Critical Care, you would enter a generic "<Site>_Med" "<Site>_Med" (ie [[GRA_Med]], [[HSC_Med]], [[STB_Med]]) for this patient so we don't have CC collectors keeping track of where regular, boarding or covid locations are.}} === Special Case - [[Visits to temporary locations]] that happen to be Boarding Locs === Occasionally a patient may be transferred to a location that is normally a [[Boarding Loc]] that we would enter or discharge to, however that location may be used as a temporary boarding location for a procedure. If after reading through the chart this is in fact the case, that [[Boarding Loc]] should not be entered, as it should be regarded as though the patient were going for any procedure and then back to their home ward location. *Sometimes [[Visits to temporary locations]] may look like boarding locations. See that page for info on making the distinction. {{Ex| Medicine patient is transferred to ICMS for a scope and is not admitted under critical care -> don't enter a [[Boarding Loc]] for ICMS }} === Special Case - parked in ER === For further information please see * [[Parked in ER]] {{Boarding Loc, Service content}} == Start/End Dates of collection == *CC Start: 2018-July-19 as [[Project Borrow arrive]] and has been renamed and continued as Boarding Loc starting 2019-Sep-01 *Med Start: 2019-Sep-01: new admissions on and after this date. *CC and Med Start Oct,1 2020 : modified according to [[PatientFollow Project]] to include ER as boarding loc. * 2020-12-16: [[Change of GRA location names from "our" names to EPR/Cognos names]] * 2022-01-01: [[Change of remaining location names from "our" names to EPR/Cognos names]] *End: there is no planned end date {{Data Integrity Check List}} == Data Use == Critical care and Medicine programs want to know this to better understand patient flow and bed utilization. === SAS Program === The SAS program calculates the time spent in a borrowed bed at each ICU stay and summarize the total bed-days in a given interval that are taken up by boarders from elsewhere and how much a certain unit is boarding elsewhere. ::Time spent in borrowed bed = Next Arrival Date_time - First Arrival Date_time ::: where Next Arrival Date_time = Dispo Date_time if there is no more next arrival date_time. The SAS program is saved in S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer.sas. *the specific macros are %BoardingLoc, %ACCUBorrow, %ICUOtherService == Background == See [[Bed borrow]] as aggregator page for other boarding and borrow related concepts. The concept of [[EMIP]]s which was similar from [[Bed borrow]] and collected separately before are now collected as part of [[Boarding Loc]]. See [[EMIP#Legacy information]] information for how they were collected before/ ==Related articles == {{Related Articles}} [[Category:L TmpV2 Data]] [[Category:Project]] [[Category:Overflow]] [[Category:EMIP]] [[Category:PatientFollow Project]] [[Category:Admit/Discharge]]

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